My faith in several of my Harvard mentors during the 1950s and 1960s has been shattered by an article that appeared this week in JAMA Internal Medicine (September 12, 2016). Cristin E. Kearns, a postdoctoral fellow at UCSF, discovered letters in the archives at Harvard, the University of Illinois and other libraries showing that from the 1960s onward, the sugar industry paid respected researchers at Harvard to write that sugar is not harmful. This incredibly-well-documented research took many hours of sorting through old letters and memos to prove that the sugar industry paid for Harvard's support. To this day, North Americans are fatter and at increased risk for diabetes, heart attacks and some cancers, in part due to recommendations paid for by the sugar industry through research grants to Harvard and other universities.

The Bombshell Showing Collusion between Big Sugar and Harvard
In the 1940s, Fred Stare, chairman of nutrition at Harvard's School of Public Health, began soliciting food companies to donate unrestricted funds for research and education.

In the early 1950s a noted researcher at the University of Minnesota, Ancel Keys blamed saturated fat and dietary cholesterol for the ever increasing rate of heart attacks, obesity and diabetes in North America, while John Yudkin at Cambridge University in England published extensively that sugar, not saturated fats and cholesterol, was responsible for this epidemic. Researchers from other universities, including Harvard, took up the debate and the war between the two factions continued for decades. Now we learn that the debate was fueled with payments to researchers by the sugar industry to prove that Yudkin was wrong. Yudkin died in 1995, still considered by many people to be a quack. The JAMA article, which was reported on the front page of the New York Times (September 12, 2016), shows that Yudkin was on the right side all along.

Dr. Kearns discovered that in 1965, John Hickson of the Sugar Research Foundation (now the Sugar Association) wrote to Harvard researchers asking them to write an article showing that sugar was safe and healthful. He paid them $6500 and asked them to review only the research papers favorable to the sugar industry. Harvard's Dr. Mark Hegsted wrote to Hickson, "We are well aware of your particular interest . . . and will cover this as well as we can." As the Harvard researchers wrote their review of the causes of diabetes and heart attacks, they sent each draft to Hickson, who responded, "Let me assure you this is quite what we had in mind, and we look forward to its appearance in print." Dr. Hegsted and Dr. Stare submitted their paper to one of the most prestigious medical journals in the world, stating that the data implicating sugar as a cause of heart attacks was extremely weak and that saturated fat and cholesterol were the actual causes (N Engl J Med, 1967 Jul 27;277(4):186-92). They wrote, "Sugar does not have a unique role in heart disease," even though they had previously published articles associating both fat and sugar with increased risk for heart attacks. Nowhere in the article did they reveal that they were paid by the Sugar Research Foundation. The New England Journal of Medicine did not begin to require financial disclosures until 1984.

This paper and others, produced by these prestigious and respected Harvard scientists under the influence and funding of the sugar industry, had an incredible influence on the entire academic community and the general public. Dr. Hegstead was appointed head of nutrition at the United States Department of Agriculture and in 1977, he and Fred Stare helped to draft the forerunner of the federal government's dietary guidelines, which blamed saturated fat and cholesterol, but not sugar, for the increasing epidemic of overweight, diabetes and heart attacks. Popular books touting low-fat diets became best sellers and thousands of low-fat food products flooded the supermarkets, often with sugar and white flour as their primary ingredients.

I Was Suckered In Too
In 1976, I asked Dr. Stare, who was a personal friend, to write the introduction to my Sportsmedicine Book. It had a section specifically stating that eating too much sugar in foods and drinks is harmful and a probable cause of obesity and heart attacks. Dr. Stare sent me a note telling me that, as an academic, he could not endorse popular books. Now I can see that his real reason was that I disagreed with Harvard's well-funded position on sugar.

I remember being a guest on Elizabeth Whelan's radio show while I was promoting my book. When I told her that sugar is harmful, she excoriated me for not knowing that sugar is harmless because it is a natural fuel for all cells in our bodies. (Whelan was a member of Harvard's Department of Nutrition and a cofounder, with Dr. Stare, of the American Council of Science and Health (ACSH). In 1980, ACSH sought major funding from Philip Morris Cigarettes and Dr. Stare assured them that "it would be to Phillip Morris's benefit").

Worse, like most doctors in the United States, I came to believe that fat was the primary culprit in the obesity epidemic and told my patients to follow a low-fat diet. In 1993, my wife, Diana, and I wrote Fat Free, Flavor Full, our first of several popular books based on restricting fat. At least we did advocate limiting sugar and other refined carbohydrates too. Now I cringe when I remember that I encouraged people to restrict the healthful fats found in plants such as avocados, nuts, olives and coconuts. Today I tell everyone that they should include these fats even if they are trying to lose weight.

The Food Industry is Still Trying to Influence Research
In an editorial accompanying Dr. Kearns' article (JAMA Internal Medicine, September 12, 2016), Marion Nestle wrote that even today, food companies continue to manipulate public opinion about foods. Dr. Nestle is professor of nutrition at New York University and Cornell who has written widely on the subject. She says, "It is almost impossible to keep up with the range of food companies sponsoring research." Last year, an article in The New York Times revealed that Coca-Cola, the world’s largest producer of sugary beverages, has provided millions of dollars in funding to researchers who sought to downplay the link between sugary drinks and obesity. Respected researchers were paid to say that lack of exercise, rather than sugar, is the main cause of obesity, diabetes and heart attacks. Most research shows otherwise. See my article on Industry Sponsored Research.

My Recommendations
Almost all scientific journals now require authors to reveal their sources of funding, so you can check to see who may be influencing the authors' opinions. The bottom line for all businesses is profit, so be skeptical of claims that any one food is more healthful than others.

Even though the explanations have changed as new research came along, my healthful lifestyle recommendations still remain basically the same:
• Base your diet on plenty of vegetables, fruits, nuts, beans, whole grains and other seeds
• Restrict meat from mammals, processed meats, all sugared drinks including fruit juices, sugar-added foods and fried foods
• Try to exercise every day
• Avoid being overweight, particularly if you store extra fat primarily in your belly
• If you are overweight or have high blood sugar levels, severely restrict all refined carbohydrates such as most dry breakfast cereals, bread and other bakery products, pasta, pretzels, chips and so forth
• Avoid smoking and recreational drugs
• Restrict or avoid alcohol

About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities.
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